FEDERAL EMERGENCY MANAGEMENT AGENCY MITIGATION DIRECTORATE TECHNICAL SERVICES DIVISION AMENDMENTS AND REVISIONS TO

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1 FEDERAL EMERGENCY MANAGEMENT AGENCY MITIGATION DIRECTORATE TECHNICAL SERVICES DIVISION AMENDMENTS AND REVISIONS TO NATIONAL FLOOD INSURANCE PROGRAM MAPS Application/Certification Forms and Instructions For Letters of Map Amendment, Conditional Letters of Map Amendment, Letters of Map Revision (Based on Fill), and Conditional Letters of Map Revision (Based on Fill) MT-1 FEMA Form SERIES, JAN 99

2 APPLICATION/CERTIFICATION FORMS FOR CONDITIONAL AND FINAL LETTERS OF MAP AMENDMENT AND LETTERS OF MAP REVISION BASED ON FILL Revised Instructions as of June 4, 2001 General Background Information In 1968, the U.S. Congress passed the National Flood Insurance Act, which created the National Flood Insurance Program (NFIP). The NFIP was designed to reduce future flood losses through local floodplain management and to provide protection for property owners against potential losses through an insurance mechanism that allows a premium to be paid for the protection by those most in need of it. Creation of the NFIP represented a major shift in Federal strategy from previous structural flood-control and disaster relief programs. As part of the agreement for making flood insurance available in a community, the NFIP requires the community to adopt floodplain management ordinances containing certain minimum requirements intended to reduce future flood losses. Therefore, the community official or agency responsible for floodplain management may be able to provide information that would be useful to a requester. This official or agency usually is responsible for engineering, public works, flood control, or planning in the community as well. Use of Application/Certification Forms The Federal Emergency Management Agency (FEMA) implemented the use of application/certification forms for requesting revisions or amendments to NFIP maps for two reasons. First, because the forms provide a step-by-step process for requesters to follow and are comprehensive, requesters are assured of providing all of the necessary information to support their requests without having to go through an iterative process of providing additional information in a piecemeal fashion. Experience has shown this to be a time-consuming and cost-intensive process. Second, because use of the forms assures that the requesters' submissions are complete and more logically structured, FEMA can complete its review in a shorter timeframe. The application/certification forms included in this package were designed to assist requesters (community officials, individual property owners, and others) in gathering the information FEMA needs to determine whether property (parcel(s) of land or structure(s)) is likely to be flooded during the flood event that has a 1% chance of being equaled or exceeded in any given year (base flood). Lands that are at risk of being inundated by the base flood are called Special Flood Hazard Areas (SFHAs). The forms in this package shall be used to request Letters of Map Amendment (LOMAs), Conditional Letters of Map Amendment (CLOMAs), Letters of Map Revision Based on Fill (LOMR-Fs), and Conditional Letters of Map Revision Based on Fill (CLOMR-Fs), as defined below. Please note that not all of the forms apply to every request. Only those forms that apply to the request should be submitted. LOMA CLOMA LOMR-F CLOMR-F A letter from FEMA stating that an existing structure or parcel of land that has not been elevated by fill would not be inundated by the base flood. A letter from FEMA stating that a proposed structure that is not to be elevated by fill would not be inundated by the base flood if built as proposed. A letter from FEMA stating that an existing structure or parcel of land that has been elevated by fill would not be inundated by the base flood. A letter from FEMA stating that a parcel of land or proposed structure that is to be elevated by fill would not be inundated by the base flood if fill is placed on the parcel as proposed or the structure is built as proposed. 1

3 If the request is being made by an individual property owner to remove a single residential structure or a single legally recorded parcel of land or portion thereof from a designated SFHA, via a LOMA or LOMR-F, the MT-EZ Form, entitled "Application Form for Single Residential Lot or Structure, Amendments and Revisions to National Flood Insurance Program Maps," may be used instead of the forms in this package. The data required to support LOMA, CLOMA, LOMR-F, and CLOMR-F requests are the same, regardless of which application/certification forms package is used. The forms in this package and the form entitled "Application Form for Single Residential Lot or Structure, Amendments and Revisions to National Flood Insurance Program Maps," shall not be used in the following instances: Requests involving changes in Base (1% annual chance) Flood Elevations (BFEs); Requests involving changes in regulatory floodway boundary delineations; Requests for properties in alluvial fan areas; Requests involving property and/or structures that have been elevated by fill placed within a regulatory floodway, channelization projects, or bridge/culvert replacement projects; or Requests involving changes in coastal high hazard areas (V zones). For such requests, the community must submit the request to FEMA in accordance with Part 65 of the NFIP regulations using the separately published MT-2 application/certification forms package entitled "Application/Certification Forms and Instructions for Conditional Letters of Map Revision, Letters of Map Revision, and Physical Map Revisions." Please note that the forms in this package may be used for property that has been inadvertently included in a V zone or a regulatory floodway. However, if the property/structure is to be removed from a V zone, it must not be located seaward of the landward toe of the primary frontal dune. Data Submission Requirements In accordance with the NFIP regulations, FEMA will use the information provided by these application/certification forms to make a determination on whether to remove a parcel of property or a structure from a designated SFHA. In certain instances, additional data that are not referenced on these forms may be required. A FEMA representative will notify the requester of any additional requirements. Applicable Regulations The regulations pertaining to LOMAs, CLOMAs, LOMR-Fs, and CLOMR-Fs are presented in Parts 65 and 70 of the NFIP regulations, published under Title 44, Chapter I, Code of Federal Regulations (CFR). The purpose of Part 70 is to provide an administrative procedure whereby FEMA will review information submitted by an owner or lessee of property who believes that his or her property has been inadvertently included in a designated SFHA. The necessity of Part 70 is due in part to the technical difficulty of accurately delineating the SFHA boundaries on an NFIP map. Part 70 procedures shall not apply if the topography has been altered since the effective date of the first NFIP map (i.e., a Flood Insurance Rate Map (FIRM) or Flood Hazard Boundary Map) showing the property to be within the SFHA. Requests involving changes in topography (such as the placement of fill) are handled under the procedures described in Part 65. 2

4 Fee Requirements Part 72 of the NFIP regulations, published at 44 CFR 72, presents information regarding the reimbursement procedure initiated by FEMA to allow for the recovery of costs associated with the review of requests for CLOMAs, CLOMR-Fs, and LOMR-Fs. There are no review and processing fees for LOMAs. The current review and processing fees for such requests, which must be received before the technical review is completed and a determination is issued, are listed below. Request for single-lot/single-structure CLOMA, CLOMR-F, and LOMR-F $400 Request for multiple-lot/multiple-structure CLOMA $700 Request for multiple-lot/multiple-structure CLOMR-F and LOMR-F $800 Request for single-lot/single-structure LOMR-F based on as-built information (CLOMR-F previously issued by FEMA) $300 Request for multiple-lot/multiple-structure LOMR-F based on as-built information (CLOMR-F previously issued by FEMA) $700 Revised fee schedules are published periodically, but no more than once annually, as a notice in the Federal Register. Payment must be submitted in the form of a check or money order, made payable in U.S. funds to the National Flood Insurance Program, or by credit card payment. Check or money order should be mailed to the following address along with the application/certification forms and data. REGIONS I-IV REGIONS V-VII REGIONS VIII-X (CT, ME, MA, NH, RI, VT, NY, PR, NJ, VI, DE, DC, MD, PA, VA, WV, AL, FL, GA, KY, MS, NC, SC, TN) FEMA LOMA Depot P.O. Box 2210 Merrifield, Virginia Attn: LOMA Manager (IL, IN, MI, MN, OH, WI, AR, LA, NM, OK, TX, IA, KS, MO, NB) FEMA LOMA Depot Indian Creek Court Beltsville, Maryland Attn: LOMA Manager (CO, MT, ND, SD, UT, WY, AZ, CA, HI, NV, AK, ID, OR, WA) FEMA LOMA Depot 3601 Eisenhower Avenue Suite 600 Alexandria, Virginia Attn: LOMA Manager Those paying by credit card must complete and submit Form 1A and forward their credit card payment along with the application/certification forms and data by fax or to the address printed on the form. Basis of Determination FEMA's determination as to whether a structure or parcel of land is outside the SFHA will be based on a comparison of the BFE with the elevation of the lowest adjacent grade to the structure (lowest ground touching the structure) or the lowest parcel elevation. If fill has been (or will be) placed, FEMA will require the community provide assurance that all applicable local, state, and federal floodplain management requirements have been met (see instructions for the Community Acknowledgement form for more information) before the property can be removed from the SFHA. Please note the following special considerations that may affect FEMA's determination: In areas of sheetflow flooding (AO Zones), the elevation of the lowest adjacent grade and the elevation of the lowest floor (including basement/crawl space) of the structure(s) must be elevated above the elevation of the highest surrounding ground by at least the amount of the depth specified on the FIRM. In addition, adequate drainage paths must be maintained to guide floodwaters around and away from the structure(s). If the lowest floor of a building has been elevated on posts, piers, or pilings above the BFE and any portion of the structure (i.e., posts, pilings, or piers including those supporting decks) is still below the BFE, the building will not be removed from the SFHA. 3

5 Response Timeframe In accordance with the procedures of Title 44, Chapter I, CFR, Part 72, FEMA will notify the requester of the determination in writing within 60 days of the date of receipt of all required data. Effect on Insurance Purchase Requirements Although FEMA may issue a LOMA or LOMR-F removing a structure(s) from the SFHA, it is the lending institution's prerogative to require flood insurance if it deems such action appropriate. If, however, the lending institution agrees to waive the flood insurance purchase requirement for a structure, the property owner is eligible for a full refund of the premium paid for the current policy year, provided that no claim is pending or has been paid on the policy in question during the same policy year. If the property owner has been required to renew his or her policy during a period when a revised NFIP map was being printed, the premium will be refunded for an additional year. To initiate processing of the refund, the property owner should provide the LOMA or LOMR-F and evidence of the waiver of the flood insurance requirement from the lending institution to the insurance agent or broker who sold the policy. Conditional Determinations To qualify for a CLOMA or CLOMR-F, the proposed project must meet the same criteria as those required for a LOMA or LOMR-F. After construction is completed or fill is placed, certified as-built information must be submitted to FEMA for a LOMA or LOMR-F to be issued. The NFIP regulations do not require that a CLOMA or CLOMR-F be requested and issued for a proposed project. Property owners and developers should note that a CLOMA or CLOMR-F merely provides comment on the proposed plan and does not amend the NFIP map. It also does not relieve Federal agencies of the need to comply in carrying out their responsibilities for providing federally undertaken, financed, or assisted construction and improvements or in their regulating and licensing activities, in accordance with the provisions of Executive Order Addresses for Submitting Requests Please submit all application/certification forms, the appropriate fee, and data to support a request to remove a structure(s) or lot(s) from the floodplain to the appropriate address listed below. REGIONS I-IV REGIONS V-VII REGIONS VIII-X (CT, ME, MA, NH, RI, VT, (IL, IN, MI, MN, OH, WI, (CO, MT, ND, SD, UT, WY, NY, PR, NJ, VI, DE, DC, AR, LA, NM, OK, TX, IA, KS, AZ, CA, HI, NV, AK, ID, OR, MD, PA, VA, WV, AL, FL, MO, NB) WA) GA, KY, MS, NC, SC, TN) FEMA FEMA FEMA LOMA Depot LOMA Depot LOMA Depot Indian Creek Court 3601 Eisenhower Avenue P.O. Box 2210 Beltsville, Maryland Suite 600 Merrifield, Virginia Attn: LOMA Manager Alexandria, Virginia Attn: LOMA Manager Attn: LOMA Manager Those paying by credit card must complete and submit Form 1A and forward their credit card payment along with the application/certification forms and data by fax or to the address printed on the form. 4

6 INSTRUCTIONS FOR COMPLETING THE PROPERTY INFORMATION FORM General Instructions The Property Information Form (Form 1) may be completed by the property owner, registered land surveyor, or registered professional engineer. To ensure a timely response to each submittal, the individual completing this form should review the form carefully to ensure all questions have been answered and all required information has been submitted. To assist in this effort, passages discussing required information have been highlighted in [bold type/red ink] on the form. Before completing the Property Information Form (Form 1), the requester must obtain one of the following documents from the County Clerk, Recorder, or Register for the community: A copy of the Plat Map for the property, showing the recordation information (e.g., Book/Volume and Page numbers or Document/Instrument number) and containing the recorder's seal and recordation date. A copy of the Deed for the property, showing the recordation information (e.g., Book/Volume and Page numbers or Document/Instrument number containing the recorder's seal and recordation date), accompanied by a tax assessor's or other suitable map showing the surveyed location of the property. The requester also must obtain a photocopy of the effective FIRM panel (including the Title Block) that shows the area in which the property is located. To determine which panel shows the property, the requester should consult the FIRM Index, which shows the outline of the mapped community and the numbers and layout of the individual FIRM panels. After locating the general area of the property by referring to major streets and streams in the vicinity, read the corresponding FIRM panel number from the Index. The FIRM should be available at the community map repository or from the community official or agency responsible for floodplain management. However, the FIRM Index and FIRM panels may be ordered from the Map Service Center for a nominal fee by calling Orders may also be faxed to the Map Service Center at Requesters should note that for multiple structure/lot requests, this form should only be completed once to describe the entire project. One form for each lot is not necessary. Specific Instructions Item 1 Provide the Community Name/County Name/State, Panel or Map Number, and Effective Date as they appear in the Title Block of the FIRM panel, as shown in Figure 1 (for maps depicting a single community) or Figure 2 (for maps covering an entire county, including all incorporated communities). 5

7 Item 2 Enter the street address if there is one. For requests involving multiple lots or structures, attach a separate piece of paper when space is insufficient. Item 3 If a street address cannot be provided, describe the property by referring to the Deed or Plat Map. The description may consist of a lot number and subdivision name, a parcel number, a tract number, or any other information provided in a Deed to identify the property. It is not necessary to reproduce a lengthy description of the property as it appears in the Deed. Item 4 Answer "a" if the SFHA designation is to be removed from the entire legally defined property shown on the Plat Map or described in the Deed. For the SFHA designation to be removed, the entire parcel as defined must be at or above the BFE. Answer "b" if the request is not for the entire property shown on the Plat Map or described in the Deed, but only for a portion of that property. In this case, a licensed land surveyor or registered professional engineer must write and certify a metes and bounds description of the subject portion. The description must be accompanied by a map showing the accurately plotted metes and bounds of that portion of the property. This map must be certified by a licensed surveyor or registered professional engineer. Answer "c" if only the structure(s) on the property, not the entire property itself, is to be removed from the SFHA. 6

8 Item 5 Answer "a" if the request is for a single structure. Answer "b" if the request is for a single lot. Answer "c" if the request is for multiple structures. Answer "d" if the request is for multiple lots. Item 8 Answer "a" if the request involves structures for which construction is complete ("as-built"), on-grade slabs have been poured, or locations have been recorded. Answer "b" if the request involves planned placement of fill, planned construction of insurable buildings, or planned improvements costing 50 percent or more of the market value of the structure before the start of construction of the improvement for which lot locations have not been recorded. Item 9 Answer "yes" if fill has been placed to elevate the structure(s); answer "no" if fill has not been placed. Fill is defined as material placed to raise the ground to or above the BFE. The common construction practice of removing unsuitable existing material (topsoil) and backfilling with select structural material is not considered the placement of fill if the practice does not alter the existing elevation, which is at or above the BFE. Also, fill that is placed before the date of the first NFIP map showing the area in a SFHA is considered natural ground. Item 10 Answer this question for proposed projects only. Answer "yes" if fill will be placed to elevate the property (land or structure(s)) to or above the BFE; answer "no" if fill is not anticipated. For "yes" answers, indicate month and year when fill will be placed. Item 11 Provide any readily available information regarding previous requests to FEMA for determinations in this area. In particular, if the request concerns a proposed project that was submitted to FEMA for comment and is now complete, please indicate that here and provide the date of FEMA's response. It is not necessary to research previous requests. Indicate all documents that are enclosed with this request. The documents to be enclosed with each request will vary, depending on the nature of the request. Not all forms are required for every request. Please review the information below to determine what documentation is required. Item 12 a. Property description documentation must be enclosed for every request and will consist of either the Plat Map (containing the recorder's stamp and recordation date) accompanied by a tax assessor's map or other suitable map showing the surveyed location of the property. The recordation data (e.g., Book, Volume, Page, Reel, Document Number, Date) must be evident on the copies of these documents so that FEMA may use the legal description of the property. In addition, FEMA must be able to identify the property exactly. If the property is not recorded on a Plat Map, a copy of a tax assessor's map or other suitable map must be submitted to aid FEMA in locating the property. 7

9 b. Property description documentation must be enclosed for every request and will consist of either the Deed (containing the recorder's stamp and recordation date) accompanied by a tax assessor's map or other suitable map showing the surveyed location of the property. The recordation data (e.g., Book, Volume, Page, Reel, Document Number, Date) must be evident on the copies of these documents so that FEMA may use the legal description of the property. In addition, FEMA must be able to identify the property exactly. If the property is not recorded on a Plat Map, a copy of a tax assessor's map or other suitable map must be submitted to aid FEMA in locating the property. c. A photocopy of the effective FIRM panel, annotated to show where the property is located, must be submitted for every request. For requests involving multiple structures or lots, the locations of the structures or lots must be certified by a licensed land surveyor or registered professional engineer to be accurate representations. The panel number and effective date of the FIRM must appear on the copy submitted. The actual map or a photographic copy must be used. A reproduction from a photocopy is unacceptable due to possible distortion. d. If the ground elevations are not clearly documented on the Elevation Information Form (Form 2), then a map certified by a registered professional engineer or licensed land surveyor must be submitted to relate the ground elevations and locations of structures or lots. The map must be labeled to indicate whether it reflects "as-built" or "proposed" conditions. e. A metes and bounds description must be submitted for requests that involve the removal of only a portion of the entire property from the SFHA. (This does not apply to requests involving only structures.) The metes and bounds description must cover the specific area to be removed, it must be tied to an identifiable starting point, and it must be certified by a licensed land surveyor or registered professional engineer. The narrative description must be accompanied by a certified map showing the area described. No portion of the area described by the metes and bounds may be below the BFE. f. The Elevation Information Form (Form 2) must be included for all requests, except requests for determinations in which the FIRM already shows property to be CLEARLY outside the SFHA. For cases in which the determination for the property or structure is uncertain, elevation data must be submitted to provide a definitive determination. This form must be completed by a licensed land surveyor or registered professional engineer. If an Elevation Certificate has been completed for a structure(s), it may be submitted in lieu of this form. The Elevation Certificate must be certified by a licensed land surveyor or registered professional engineer. g. The Community Acknowledgment of Requests Involving Fill Form (Form 4) must be submitted for all requests involving the placement of fill in the SFHA to elevate property (parcel(s) or structure(s)). The form requires the Chief Executive Officer (CEO) of the community or an official designated by the CEO to provide assurance that all applicable local, state, and federal floodplain management requirements have been met (see instructions for Community Acknowledgement of Requests Involving Fill form for more detail). h. The certification of fill placement form is no longer required. Rather, the Community Acknowledgement of Requests Involving Fill form will take its place. Please see the instructions for that form for more details. i. Specify and attach other information that is necessary for FEMA to make a determination on the request. Item 13 The appropriate review and processing fee must be submitted for requests involving proposed projects and for requests involving the placement of fill. No fee is required to obtain a determination based on existing conditions (i.e., a LOMA) as long as no fill has been placed. Refer to page 2 of this application/certification forms package for assistance in determining the appropriate fee. Item 14 Provide complete name, address, and telephone number of applicant. Provide signature where indicated to certify the accuracy of the information provided in, and submitted with, the form. Please add the date on which the form has been completed. 8

10 INSTRUCTIONS FOR COMPLETING THE CREDIT CARD INFORMATION FORM If the revision request involves a fee, the option of paying with a credit card is available. Accepted credit cards include Visa, and Mastercard. Please include the case number if known and clearly print all information. 9

11 General Instructions INSTRUCTIONS FOR COMPLETING THE ELEVATION INFORMATION FORM The Elevation Information Form (Form 2) must be completed by a licensed land surveyor or registered professional engineer. To ensure a timely response to each submittal, the individual completing this form should review the form carefully to ensure all questions have been answered and all required information has been submitted. To assist in this effort, passages discussing required information have been highlighted in [bold type/red ink] on the form. For a licensed land surveyor or registered professional engineer to complete this form, it will be necessary to obtain the effective FIRM panel, effective Flood Boundary and Floodway Map (FBFM) panel (if printed), and Flood Insurance Study (FIS) report that cover the area in which the property is located. These can be obtained from the community map repository or can be ordered from the Map Service Center for a nominal fee by calling Orders may also be faxed to the Map Service Center at For multiple-lot or multiple-structure requests, this form should be completed only once, and submitted with a complete Summary of Elevations-Individual Lot Breakdown Form (Form 5) showing the appropriate elevations for each lot. Item 1 Provide the community name as it appears in the Title Block of the FIRM panel that shows the area in which the property is located. Item 2 Provide lot/block numbers and subdivision name, street address, or tract/parcel number. Item 3 Provide the name the source of the flooding (i.e., give the name of the stream, river, lake, bay, or ocean) as it appears on the FIRM or note whether there is ponding or shallow flooding. Item 4 List all flood insurance risk zones shown on the FIRM that affect the property (e.g., A, AE, A1-A30, A99, AO, AH, VE, V1-V30, B, C, X, D). Item 5 The regulatory floodway is the channel of a river or other watercourse that must be reserved to carry the floodwaters efficiently. If a floodway has been adopted by the community, it will be shown on the FBFM or FIRM. No fill may be placed in a regulatory floodway. Answer "yes" if the area of the property is in the regulatory floodway; answer "no" if no portion of the property is in the regulatory floodway. Answer "yes" if existing/planned structure(s) is/will be in the regulatory floodway; answer "no" if no structure(s) is/will be in the regulatory floodway. Item 6 Answer "yes" if the area of the property is in an area of subsidence or uplift; answer "no" if the area of the property is not in an area of subsidence or uplift. In areas of subsidence or uplift, the elevations shown on this document must be based on the most recent releveling of a National Geodetic Survey or other acceptable benchmark. This is required to ensure that the determination is based on a proper comparison between the published BFE and the ground elevation. 10

12 Items 7 and 8 List the elevation to the nearest 0.1 foot and identify the datum to which the elevation is referenced (e.g., NGVD, NAVD, MSL). Preliminary data produced while a FEMA study/restudy is underway cannot be used to support a request for a LOMA, CLOMA, LOMR-F, or CLOMR-F. Elevations presented should be referenced to the same datum shown on the FIRM and in the FIS report. Use the information below as guidance. Detailed Analysis A determination of the 1% annual chance water-surface elevation shall be made using the BFE or depth presented in the FIS report (in the "Summary of Elevations" table or on the Flood Profiles). If this FIS report information does not exist, then provide the one that is shown on the FIRM. (Elevations shown on the FIRM are rounded to the nearest whole foot.) Requests based on flood elevations or depths that are different from those shown on the FIRM or in the FIS report may be processed under other administrative procedures. Zone AE or A1-A30 (riverine flooding): After locating the property on the FIRM or FBFM, use the nearest lettered cross section or physical feature to locate the property and the corresponding BFE on the Flood Profile in the FIS report. Zone AE or A1-A30 (coastal flooding): Obtain the BFE from the FIRM panel and compare it to the corresponding value presented in the "Summary of Stillwater Elevations" table in the FIS report. If the table value is within 0.4 foot of the BFE on the FIRM (i.e., no wave runup), use the table value; if the BFE on the FIRM is more than 0.5 foot greater than the table value (i.e., includes wave runup), use the BFE on the FIRM. Zone AH or A1-A30 (shallow flooding): Obtain the BFE from the FIRM panel or FIS report if there is no Flood Profile. Zone AO (shallow flooding): Obtain the depth from the FIRM panel. Zone VE or V1-V30 (Coastal High Hazard Zone): Obtain the BFE from the FIRM panel and compare it to the corresponding value presented in the "Summary of Stillwater Elevations" table in the FIS report. If the table value is within 0.4 foot of the BFE on the FIRM (i.e., no wave runup), use the table value; if the BFE on the FIRM is more than 0.5 foot greater than the table value (i.e., includes wave runup), use the BFE on the FIRM. If a property/structure is to be removed from a Zone VE or V1-V30, it must not be located seaward of the landward toe of the primary frontal dune. Approximate Analysis If FEMA has not specified BFEs for the area, data may be provided to substantiate a BFE for the property in question. These data may be obtained from an authoritative source, such as the U.S. Army Corps of Engineers, U.S. Geological Survey, U.S. Soil Conservation Service, or a State or local water resource department. Alternatively, data prepared and certified by a registered professional engineer may be submitted. Sufficient technical information should be provided to support the elevation, and must include Form 3, Hydrologic Analysis Form, and Form 4, Riverine Hydraulic Analysis Form, from the previously referenced MT-2 application/certification forms package. Item 9 List the elevation and identify the datum to which the elevation is referenced only for requests to remove the SFHA designation from one or more parcel(s) of land. Item 10 List the elevation and identify the datum to which the elevation is referenced only for requests to remove the SFHA designation from one or more structures. The required elevation is that of the lowest ground touching the structure including any attached decks. For structures built on posts, piers, or pilings, the elevation of the lowest ground touching the posts, piers, or pilings must be submitted. 11

13 Item 11 The elevation of the lowest floor is no longer required. Item 12 Requesters should also indicate whether the elevations in items 9 and 10 (excluding 11 because it is no longer required) are proposed or existing. Answer a if the elevations are proposed and b if they are existing. Item 13 Identify the conversion factor to convert the elevation data submitted in support of the request to the effective FIS datum. Item 14 Answer "yes" if a completed copy of the Summary of Elevations-Individual Lot Breakdown Form (Form 5) and a map certified by a licensed land surveyor or registered professional engineer have been included with the request; answer "no" and provide a brief explanation if the request if for multiple lots and/or structures and the form and map have not been provided. Item 15 Provide all requested information to certify the accuracy of the information provided in and with this form. If FEMA has specified a BFE for the area in which the property is located or the elevation was obtained from an authoritative source, the form may be certified by either a registered professional engineer or a licensed land surveyor. If FEMA has not specified a BFE for the area and a registered professional engineer has determined the elevation based on alternative data, Items 7 and 8 must be certified by a registered professional engineer, but the form may be certified by either a registered professional engineer or a licensed land surveyor. 12

14 INSTRUCTIONS FOR COMPLETING OPTIONAL FORMS General While Forms 1 and 2 must be completed for all requests, Forms 3, 4, and 5 must only be completed when they are applicable. Instructions for completing each of these forms are provided below. Certification of Fill Placement Form The Certification of Fill Placement form is no longer required. Rather, the Community Acknowledgement of Requests Involving Fill form will take its place. Please see the instructions for that form for more details. Community Acknowledgment of Requests Involving Fill Form The Community Acknowledgment of Requests Involving Fill Form (Form 4) is required for all requests involving the placement of fill existing or proposed. A community official responsible for floodplain management must sign this form. It will act as assurance that all applicable Federal, State, and local floodplain management requirements have been met including those noted below: i) Existing residential structures built in the SFHA have their lowest floor elevated to or above the base flood; ii) The participating community has determined the land and any existing or proposed structures to be removed from the SFHA are reasonably safe from flooding, and that they have on file, available upon request by FEMA, all supporting analyses and documentation used to make that determination; iii) The participating community has issued permits for all existing and proposed construction or other development; iv) All necessary permits have been received from those governmental agencies where approval is required by Federal, State, or local law; and v) Fill has not been placed in a regulatory floodway which causes a rise in flood elevations associated with the base flood discharge. For the purposes of flood map revisions, reasonably safe from flooding means base flood waters will not inundate the land or damage structures to be removed from the SFHA and that any subsurface waters related to the base flood will not damage existing or proposed buildings. To assist communities in determining if a property or structure, existing or proposed, is reasonably safe from flooding, FEMA has published Technical Bulletin This bulletin outlines safe building practices, which when followed, reduces the risk of flood damage to a property or structure. Community Officials interested in obtaining copies of this bulletin should visit our Internet site at Community Officials that do not have Internet access should contact the FEMA Map Assistance Center (FMAC) toll free at FEMA MAP ( ) and request a copy of this Technical Bulletin be mailed. Summary of Elevations Individual Lot Breakdown Form The Summary of Elevations Individual Lot Breakdown Form (Form 5) must be completed for requests involving multiple lots and/or multiple structures. The form must be completed and signed by a licensed land surveyor or registered professional engineer. In completing the form, the licensed land surveyor or registered professional engineer should note the following: 1. The community name and the subject property address shown in Items 1 and 2 of the Property Information Form must appear in the spaces provided. 2. Elevations for each lot or structure must be provided. 3. The lowest lot elevation must be provided for any request to remove the SFHA designation from an entire parcel of land. 13

15 4. The elevation of the lowest floor is no longer required. However, structures built in the SFHA shown on the flood map whose lowest floor is below BFE are in violation of the minimum floodplain management requirements set forth at 44 CFR section 60.3(c)(2). Should you have questions regarding this requirement please contact the FEMA Regional Mitigation Director whose phone number and address can be found at or by calling our Map Assistance Center at FEMA-MAP. 5. The elevation of the lowest adjacent grade (including any attached decks) of the structures must be provided for ALL requests to remove the SFHA designation from structures. For requests involving structures, the requester should indicate whether the elevation provided is for an existing structure or a proposed structure by adding "(E)" or "(P)" after the elevation. 14

16 FEDERAL EMERGENCY MANAGEMENT AGENCY PROPERTY INFORMATION O.M.B. Burden No Expires May 31, 2001 PUBLIC BURDEN DISCLOSURE NOTICE Public reporting burden for this form is estimated to average 1.63 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and reviewing the form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Federal Emergency Management Agency, 500 C Street, S.W., Washington, DC 20472; and to the Office of Management and Budget, Paperwork Reduction Project ( ), Washington, DC You are not required to respond to this collection of information unless a valid OMB Control Number is displayed in the upper right corner of this form. This form may be completed by the property owner, registered land surveyor, or registered professional engineer 1. Community Name of NFIP map panel on which the property is located: County: State: Panel or Map Number: Effective Date: 2. Street Address of Property: 3. Description of Property Lot and Block (if a street address cannot be provided): 4. Are you requesting that the SFHA designation be removed from (a) all of the land within the bounds of the property, (b) a portion of land within the bounds of the property (a certified metes and bounds description of the area to be removed is required), or (c) the structure(s) on the property? (Answer "a," "b," or "c") 5. Is this request for (a) a single structure, (b) a single lot, (c) multiple structures, (d) multiple lots? (Answer "a," "b," "c" or d ) 6. What is the type of construction? (a) crawl space; (b) slab on grade; (c) basement; (d) other (explain). (Answer a, b, c, or d ) 7. Is this request prior to the transfer of ownership of the property in question from a developer to an individual property owner? Yes No 8. Is this request for (a) existing conditions, or (b) proposed project? (Answer "a" or "b") 9. Has fill been placed on the property to elevate the ground elevation of the property, to elevate a structure(s), or to elevate the ground elevations around a structure? If yes, when? 10. For proposed projects, will fill be placed to elevate this land or structure? 11. If known, list the case number and/or the street address of previous requests that have been submitted to FEMA for this property or adjacent properties? 12. One of the following documents is required of all cases: I have enclosed the following documents in support of this request: a. Copy of the Subdivision Plat Map (with recordation data and stamp of the Recorder s Office) OR b. Copy of the property Deed (with recordation data and stamp of the Recorder s Office), accompanied by a tax assessor s map or other suitable map showing the surveyed location of the property with respect to local streets and watercourses. (For these maps a map scale must be provided and they should not be reduced or enlarged.) PLEASE REFER TO THE INSTRUCTIONS FOR THE APPROPRIATE MAILING ADDRESS FEMA Form Property Information Form MT-1 Form 1 Page 1 of 2

17 The following documents should be enclosed as applicable: c. Copy of the effective FIRM panel on which the property location has been accurately plotted (if the request is for more than one lot/structure, this location must be certified by a licensed land surveyor or registered professional engineer) d. A map showing the location of any structures existing on or proposed for the property (certified by a licensed land surveyor or registered professional engineer) e. Metes and bounds description and accompanying map of the portion of the property to be removed from the SFHA (certified by a licensed land surveyor or registered professional engineer) (only if the request is for a portion of land within the bounds of the property, not the entire lot or the structure(s) only) f. Form 2 Elevation Information form or A FEMA NFIP Elevation Certificate may be submitted in lieu of the Elevation Information form (for structures/property located in Zone AO see instructions for further guidance.) g. Form 4 Community Acknowledgment form (only if fill has been or will be placed) h. Form 3 Certification of Fill Compaction form (only if fill has been or will be placed and the request is not for an existing single residential structure) i. Additional information: please specify 13. PAYMENT ENCLOSED Processing fee (see instructions for processing fees and exemptions) $ (Type of request) (amount enclosed) Check or money order only. Make check or money order payable to: National Flood Insurance Program. If paying by Visa or Mastercard, please complete and submit the Credit Card Information Form (Form 1A), which follows this form. 14. All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement may be punishable by fine or imprisonment under Title 18 of the United States Code, Section Applicant s Name: (please print or type) Company: Mailing Address: (please print or type) Daytime Telephone Number: Fax Number: Date Signature of Applicant (required) FEMA Form Property Information Form MT-1 Form 1 Page 2 of 2

18 FEDERAL EMERGENCY MANAGEMENT AGENCY CREDIT CARD INFORMATION O.M.B. Burden No Expires April 30, 2001 PUBLIC BURDEN DISCLOSURE NOTICE Public reporting burden for this form is estimated to average 6 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and reviewing the form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Federal Emergency Management Agency, 500 C Street, S.W., Washington, DC 20472; and to the Office of Management and Budget, Paperwork Reduction Project ( ), Washington, DC You are not required to respond to this collection of information unless a valid OMB Control Number is displayed in the upper right corner of this form. If paying by credit card, this form must be completed. THIS FORM SHOULD NOT BE INCLUDED WITH THE REST OF THE FORMS PACKAGE. IT MUST BE MAILED OR FAXED TO: Federal Emergency Management Agency Revisions Fee-Collection System Administrator P.O. Box 3173 Merrifield, Virginia Fax: (703) Case # (if known) Amount: $ FEE ADDITIONAL FEE INVOICE VISA MASTERCARD CARD NUMBER: EXPIRATION DATE: Signature NAME (AS IT APPEARS ON CARD): (please print) ADDRESS: (for your credit card receiptplease print) DAYTIME PHONE: NOTICE: FORM. A COPY OF FORM 1, BEING SUBMITTED FOR THIS REQUEST MUST BE ATTACHED TO THIS FEMA Form 81-87E Credit Card Information Form MT-1 Form 1A

19 FEDERAL EMERGENCY MANAGEMENT AGENCY ELEVATION INFORMATION O.M.B. Burden No Expires May 31, 2001 PUBLIC BURDEN DISCLOSURE NOTICE Public reporting burden for this form is estimated to average 0.63 hour per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and reviewing the form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Federal Emergency Management Agency, 500 C Street, S.W., Washington, DC 20472; and to the Office of Management and Budget, Paperwork Reduction Project ( ), Washington, DC You are not required to respond to this collection of information unless a valid OMB Control Number is displayed in the upper right corner of this form. This form must be completed by a registered professional engineer or licensed land surveyor. These forms should not be used for requests involving Channelization, Bridges/Culverts, or Fill in the FEMA-Designated (regulatory) Floodway; instead, forms entitled Revisions to National Flood Insurance Program Maps (MT-2) should be used. The Elevation Information Form must be included for all requests, unless the request is for a determination in which the FIRM already shows the property to be CLEARLY outside the SFHA. Cases in which the determination for the property or structure is uncertain will require the submittal of elevation data to provide a definitive determination. If an Elevation Certificate has been completed for the subject property, it may be submitted in lieu of this form. (See instructions for details) 1. Community Name: 2. Legal Description of Property: 3. Flooding Source: 4. Based on the FIRM, this property is located in Zone(s): 5. Is any portion of this property located in the regulatory floodway? Yes No Are any structures (existing or proposed) located in the regulatory floodway? Yes No 6. Is this area subject to land subsidence or uplift? Yes No If yes, what is the date of the current releveling? For items 7-11 multiple lots/structures, complete the appropriate column(s) of the Summary of Elevations - Individual Lot Breakdown form, identifying the elevation for each lot/structure. To support items 9, 10, and 11, please note a map (certified by a licensed surveyor or registered professional engineer) may be required to relate the ground elevations and locations of structures or lots. The map should indicate whether it reflects as-built or proposed conditions. 7. What is the BFE for this property? ( Provide elevation to nearest tenth of a foot and datum) Elevation Datum (NGVD, NAVD or other) 8. How was the BFE determined? ( attach a copy of the Flood Profile or table from the FIS report, if appropriate, a copy of a letter from a state agency establishing a BFE, or other necessary supporting information including Forms 3 and 4 from forms entitled, "Revisions to National Flood Insurance Program Maps" (MT-2)). 9. If this request is to remove the SFHA designation from a parcel of land or lot(s), what is the existing or proposed elevation of the lowest grade; that is, the lowest ground on the property or within the metes and bounds description of the portion being removed? (Provide elevation to nearest tenth of a foot and datum) Elevation Datum PLEASE REFER TO THE INSTRUCTIONS FOR THE APPROPRIATE MAILING ADDRESS FEMA Form 81-87A Elevation Information Form MT-1 Form 2 Page 1 of 2

20 10. If this request is to remove the SFHA designation from a structure(s), what is the elevation of the existing or proposed lowest adjacent grade; that is, the lowest ground touching the structure, including any attached decks or garage? (Provide elevation to nearest tenth of a foot and datum) Elevation Datum 11. If fill has been/will be placed to elevate the structure(s) on this property, what is the existing or proposed elevation of the lowest floor, including basement, and/or attached garage? (Provide elevation to nearest tenth of a foot and datum) Elevation Datum 12. Are the measurements in items 9-11 based on (a) proposed or (b) existing conditions? 13. If any of the above elevations were computed based on a datum different than the effective FIS, what is the conversion factor? FIS Datum = Local Datum +/- feet 14. All information submitted in support of this request is correct to the best of my knowledge. I understand that any false statement may be punishable by fine or imprisonment under Title 18 of the United States Code, Section Name (please print or type): Title (please print or type): Registration No.: Expiration Date: State: Telephone Number: Signature Date Seal (Optional) FEMA Form 81-87A Elevation Information Form MT-1 Form 2 Page 2 of 2

21 FEDERAL EMERGENCY MANAGEMENT AGENCY CERTIFICATION OF FILL PLACEMENT O.M.B. Burden No Expires May 31, 2001 PUBLIC BURDEN DISCLOSURE NOTICE Public reporting burden for this form is estimated to average.35 hour per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and reviewing the form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Federal Emergency Management Agency, 500 C Street, S.W., Washington, DC 20472; and to the Office of Management and Budget, Paperwork Reduction Project ( ), Washington, DC You are not required to respond to this collection of information unless a valid OMB Control Number is displayed in the upper right corner of this form. Community Name Property Name or Address The Fill is: Existing Proposed I hereby certify that fill placed on the property to raise the ground surface to or above the base flood elevation in order to gain exclusion from a Special Flood Hazard Area meets the criteria of Title 44 of the Code of Federal Regulations, Section 65.5(a)(6), listed below. For proposed fill, I hereby certify that it is designed in accordance with these criteria. *Please note* Both Section 1 and Section 2 must be certified; however, different individuals may certify them. SECTION 1 1. The fill has been compacted to 95 percent of the maximum density obtainable with the Standard Proctor Test method or an acceptable equivalent method for (check one of the following): Name (please print or type): a. Fill pads prepared for the foundations of residential or commercial structures b. Entire legally defined parcel (Note: if the location of fill pads has not been determined, the fill over the entire legally defined parcel must be compacted to the above criteria). Signature Date Community Official's Title or Engineer's Seal/Registration Number SECTION 2 2. Fill slopes for granular materials are not steeper than one vertical on one-and-one-half horizontal (steeper slopes must be justified); and 3. Adequate erosion protection is provided for fill slopes exposed to moving flood waters (slopes exposed to flows with velocities of up to 5 feet per second (fps) during the base flood must, at a minimum, be protected by a permanent cover of grass, vines, weeds, or similar vegetation; slopes exposed to flows with velocities greater than 5 fps during the base flood must, at a minimum, be protected by appropriately designed stone, rock, concrete, or other durable products). Name (please print or type): Signature Date Community Official's Title or Engineer's Seal/Registration Number PLEASE REFER TO THE INSTRUCTIONS FOR THE APPROPRIATE MAILING ADDRESS FEMA Form 81-87B Certification of Fill Placement Form MT-1 Form 3